Provider Demographics
NPI:1043278054
Name:AZAM, SEEMA (MD)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:
Last Name:AZAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 LITTLETON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3198
Mailing Address - Country:US
Mailing Address - Phone:978-577-1946
Mailing Address - Fax:978-692-4716
Practice Address - Street 1:133 LITTLETON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3198
Practice Address - Country:US
Practice Address - Phone:978-577-1946
Practice Address - Fax:978-692-4716
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2014-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ27359Medicare ID - Type Unspecified
MAG78928Medicare UPIN